Length of stay following percutaneous left atrial appendage occlusion: Data from the prospective, multicenter Amplatzer Amulet Occluder Observational Study

• Published in: PloS one Vol. 16; no. 8; p. e0255721
• Main Authors: Piayda, Kerstin, Afzal, Shazia, Nielsen-Kudsk, Jens Erik, Schmidt, Boris, Mazzone, Patrizio, Berti, Sergio, Fischer, Sven, Lund, Juha, Montorfano, Matteo, Hildick-Smith, David, Gage, Ryan, Zhao, Hong, Zeus, Tobias
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 10-08-2021; Public Library of Science (PLoS)
• Subjects: Atrial fibrillation; Biology and Life Sciences; Cardiac arrhythmia; Cardiology; Care and treatment; Complications; Diagnosis; Embolisms; Embolization; Engineering and Technology; Health risks; Heart failure; Hematoma; Hospital utilization; Hospitals; Length of stay; Medicine and Health Sciences; Mortality; Observational studies; Occlusion; Patients; Pulmonology; Research and Analysis Methods; Stroke; United States; Denmark; Italy; Minnesota; United States > US; Germany; Aarhus Denmark
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0255721

To evaluate factors influencing the length of stay in patients undergoing percutaneous left atrial appendage occlusion (LAAO). Patient characteristics, procedural data and the occurrence of serious adverse events were analyzed from the Amplatzer.sup.TM Amulet.sup.TM Occluder Observational Study. Patients were divided into three groups: same day (S, 0day, n = 60, 5.6%) early (E, 1day, n = 526, 48.9%), regular (R, 2-3days, n = 338, 31.4%) and late (L, [greater than or equal to]4days, n = 152, 14.1%) discharge and followed up for 60 days. Procedure and device related SAE during the in-hospital stay (S: 0.0% vs. E: 1.0% vs. R: 2.1% vs. L: 23%, p<0.0001) were a major trigger for a prolonged in-hospital stay. Of the 37 subjects in the late discharge group with an SAE prior to discharge, cardiac or bleeding complications were the most common underlying conditions, occurring in 26 subjects. Multinomial logistic analysis only identified HAS-BLED score as an independent influencing factor (p = 0.04) for a late discharge. After 60 days, mortality tended to be greatest in the late discharge group (S: 0.0% vs. E: 1.0% vs. R: 1.2% vs. L: 3.3%, p = 0.1066). Over half of the subjects receiving an Amplatzer Amulet occluder were discharged within 1 day of the implant procedure. Serious adverse events were a major trigger for a late discharge after LAAO. Increased HAS-BLED score was associated with a prolonged in-hospital stay.